by Anne Perry
So Hester was, with some difficulty, learning to become domestic and trying to do it with a modicum of grace.
Her real passion was still to reform nursing, as it had been ever since she had come home from the Crimea. Lady Callandra Daviot shared her feelings, which was why Hester was standing in the North London Hospital now waiting for Callandra to come and recount the success or failure of their latest attempt.
She heard the door opening and swung around. Callandra came in, her hair sticking out in tufts as if she had run her fingers through it, her face set tight and hard with anger. There was no need to ask if she had succeeded.
Callandra had dignity, courage and good humor, but not even her dearest friend would have said she was graceful. In spite of the best efforts of her maid, her clothes looked as if she paid no regard to them, merely picking up what first came to her hand when she opened the wardrobe door. Today it was a green skirt and a blue blouse. It was warm enough inside the hospital for her not to wear whatever jacket she had chosen.
"The man is a complete idiot!" she said furiously. "How can anyone see to diagnose what ails a person for any of a hundred diseases and still be blind as a bat to the facts before his face?"
"I don’t know," Hester admitted. "But it happens frequently."
The door was still wide open behind Callandra. She turned on her heel and marched out again, leaving Hester to follow after her.
"How many hours are there in a day?" Callandra demanded over her shoulder.
"Twenty-four," Hester replied as they reached the end of the passage and went through the now-empty operating theater with its table in the center, benches for equipment, and the railed-off gallery on three sides for pupils and other interested parties to observe.
"Exactly," Callandra agreed. "And how much of that time can a surgeon be expected to care for his patient personally? One hour if the patient is important—less if he is not. Who cares for him the rest of the time?" She opened the farther door into the wide passageway that ran the length of the entire ground floor.
"The resident medicine officer—" Hester began.
"Apothecary!" Callandra said dismissively, waving her hand in the air.
Hester closed the door behind them. "They prefer to call them resident medicine officers now," she remarked. "And the nurses. I know your point. If we do not train nurses, and pay them properly, everyone else’s efforts are largely wasted. The most brilliant of surgeons is still dependent upon the care we give his patients after he has treated them."
"I know that." Callandra hesitated, deciding whether to go right, towards the casualty room, or left, past the postmortem room to the eye department and the secretary’s office and the boardroom. "You know that." She decided to go left. "Dr. Beck knows that." She spoke his name quite formally, as if they had not been friends for years—and not cared for each other far more than either dared say. "But Mr. Ordway is very well satisfied with things as they are! If it were up to him we’d still be wearing fig leaves and eating our food raw."
"Figs, presumably," Hester said dryly. "Or apples?"
Callandra shot her a sharp look. "Figs," she retorted with absolute certainty. "He’d never have had the courage to take the apple!"
"Then we would not be wearing the fig leaves, either, heaven preserve us," Hester pointed out, hiding her smile.
"Marriage has made you decidedly immodest!" Callandra snapped, but there was satisfaction in her voice. She had long wished Hester’s happiness, and had once or twice alluded to fears that her friend might become too wasp-tongued to allow herself the chance.
They reached the end of the corridor and Callandra turned right, towards the boardroom. She hesitated in her step so slightly that had Hester not felt the trepidation herself, she might not have noticed it at all.
Callandra knocked on the door.
"Come in!" the voice inside commanded.
Callandra pushed it open and went inside, Hester on her heels.
The man sitting at the large table was of stocky build, his hair receding from a broad brow, his features strong and stubborn. His was not a handsome face, but it had a certain distinction. He was extremely well dressed in a suit of pinstriped cloth which must have been very warm on this midsummer day. His white collar was high and stiff. A gold watch chain was draped across his broad chest.
The expression on his face tightened when he recognized Callandra. It positively flinched when he saw Hester behind her.
"Lady Callandra ..." He half rose from his seat as a gesture of courtesy. She was not a nurse or an employee, however much of a thorn in his side she might be. "What can I do for you?" He nodded at Hester. "Miss Latterly."
"Mrs. Monk," Callandra corrected him with satisfaction.
His face flushed slightly and he gave a perfunctory nod towards Hester in mute apology. His hand brushed the papers in front of him, indicating how busy he was and that only polite-ness prevented him from pointing out the fact that they were interrupting him.
"Mr. Thorpe," Callandra began purposefully, "1 have just spoken again with Mr. Ordway, to no avail. Nothing I can say seems to make him aware of the necessity for improving the conditions—"
"Lady Callandra," he cut across her wearily, his voice hard-edged. "We have already discussed this matter a number of times. As chairman of the governors of this hospital, I have a great many considerations to keep in mind when I make my decisions, and cost has to be high among them. I thought I had adequately explained that to you, but I perceive that my efforts were in vain." He drew breath to continue, but this time Callandra interrupted him.
"I understood you perfectly, Mr. Thorpe. I do not agree. All the money in the world is wasted if it is spent on operating upon a patient who is not adequately cared for afterwards...."
"Lady Callandra ..." He sighed heavily, his patience exceedingly thin. His hand moved noisily over the papers, rustling them together. "As many patients survive in this hospital as in most others, if not rather more. If you were as experienced in medicine as I am, you would realize that it is regrettably usual for a great number of patients to die after surgery. It is something that cannot be avoided. All the skill in the world cannot—"
Hester could endure it no longer.
"We are not talking about skill, Mr. Thorpe," she said firmly. "All that is required to ease at least some of the distress is common sense! Experience has shown that—"
Thorpe closed his eyes in exasperation. "Not Miss Nightingale again, Miss... Mrs. Monk." He jerked his hand sharply, scattering the papers over the desktop. "I have had enough letters from that woman to paper my walls! She has not the faintest ideas of the realities of life in England. She thinks because she did fine work in utterly different circumstances in a different country that she can come home again and reorganize the entire medical establishment according to her own ideas. She has delusions both as to the extent of her knowledge and the degree of her own importance."
"It’s not about personal importance, Mr. Thorpe," Hester replied, staring straight at him. "Or about who gets the praise— at least, it shouldn’t be. It is about whether a patient recovers or dies. That is what we are here for."
"That is what I am here for, madam," he said grimly. "What you are here for, I have no idea. Your friends would no doubt say it is from a devotion to the welfare of your fellow human beings in their suffering. Your detractors might take the view that it is to fill your otherwise empty time and to give yourself a feeling of importance you would not have in the merely domestic setting of running your own household."
Hester was furious. She knew perfectly well that losing her temper would also lose her the argument, and it was just possible that Thorpe knew that also. Personally, she didn’t think he had the wit. Either way, she had no intention of catering to him.
"There are always people willing to detract with a spiteful remark," she answered with as good a smile as she could manage. "It is largely made from ignorance and meanness of spirit. I am sure you have more sense than to pay attention to them.
I am here because I have some practical experience in nursing people after severe injury, whether caused by battle or surgery, and as a consequence have learned some methods that work rather better than those currently practiced here at home."
"You may imagine so." Thorpe looked at her icily. His light brown eyes were large but a trifle deep-set. His lashes would have been the envy of many a woman.
Hester raised her brows very high. "Is it not better that the patient lives than that he dies?"
Thorpe half rose from his chair, his face pink. "Do not be flippant with me, madam! I would remind you that you have no medical training whatsoever. You are unlearned and totally ignorant, and as a woman, unsuited to the rigors of medical science. Just because you have been of use abroad to soldiers in the extremity of their injuries while fighting for Queen and country, do not imitate the unfortunate Miss Nightingale in imagining that you have some sort of role to teach the rest of us how we should behave."
Hester was quite well aware of Florence Nightingale’s nature, far more so than Fermin Thorpe, who knew her only through her voluminous correspondence to everyone even remotely concerned with hospital administration. Hester knew Miss Nightingale’s courage, her capacity for work and her spirit which fired the labor and sacrifice of this; and also her inexhaustible nagging and obsession with detail, her high-handed manner and the overwrought emotions which drained her almost to the point of collapse. She would certainly outlast Fermin Thorpe and his like—by sheer attrition, if nothing else.
Experience of the Crimea, of its hardships and its rare victories, above all of its spirit, calmed the retort that came to her tongue.
"I am sure Miss Nightingale believes she is sharing the reward of experiences you have been unable to have for yourself," she said with curdling sweetness, "having remained here in England. She has not realized that her efforts are not welcome."
Thorpe flushed scarlet. "I’m sure she means well," he replied in a tone he presumably intended to be placating, although it came through his teeth. "She simply does not realize that what was true in Sebastopol is not necessarily true in London."
Hester took a deep breath. "Having been in both places, she may imagine that, as far as the healing of injury is concerned, it is exactly the same. I suffer from that illusion myself."
Thorpe’s lips narrowed to a knife-thin line.
"I have made my decision, madam. The women who work in this establishment are quite adequate to our needs, and they are rewarded in accordance with their skills and their diligence. We will use our very limited financial resources to pay for that which best serves the patients’ needs—namely, skilled surgeons and physicians who are trained, qualified and experienced. Your assistance in keeping good order in the hospital, in offering encouragement and some advice on the moral welfare of the patients, is much appreciated. Indeed," he added meaningfully, "it would be greatly missed were you no longer to come. I am sure the other hospital governors will agree with me wholeheartedly. Good day."
There was nothing to do but reply as civilly as possible and retreat.
"I suppose that man has a redeeming virtue, but so far I have failed to find it," Callandra said as soon as they were outside in the corridor and beyond overhearing.
"He’s punctual," Hester said dryly. "He’s clean," she went on after a minute’s additional thought.
They walked hastily back towards the surgeons’ rooms, passing an elderly nurse, her shoulders stooping with the weight of the buckets she carried in each hand. Her face was puffy, her eyes red-rimmed. "And sober," Hester added.
"Those are not virtues," Callandra said bitterly. "They are accidents of breeding and circumstance. He has the opportunity to be clean and no temptation to be inebriated, except with his own importance. And that is of sufficient potency that after it alcohol would be redundant."
They passed the apothecary’s rooms. Callandra hesitated as if to say something, then apparently changed her mind and hurried on.
Kristian Beck came out of the operating theater, but he had his coat on and his shirt cuffs were clean, so apparently he had not been performing surgery. His face lit when he recognized Callandra, then he saw her expression.
"Nothing?" he said, more an answer than a question. He was of barely average height. His hair was receding a little above his temples, but his mouth had a remarkable passion and sensitivity to it, and his voice had a timbre of great beauty. Hester was aware that his friendship with Callandra was more profound than merely the trust of people who have the same compassion and the same anger, and the will to fight for the same goals. How personal it was she had not asked. Kristian was married, though she had never heard him speak of his wife. Now he was regarding Callandra earnestly, listening to her recount their conversation with Thorpe. He looked tired. Hester knew he had almost certainly been at the hospital all night, seeing some patient through a crisis and snatching a few hours’ sleep as he could. There were shadows around his eyes and his skin had very little color.
"He won’t even listen," Callandra said. She had been weary the moment before, and angry with Thorpe and with herself. Now suddenly her voice was gentler, and she made the effort to hide her sense of hopelessness. "I am not at all sure I approached him in the best way...."
Kristian smiled. "I imagine not," he said with mild humor, full of ruefulness and affection. "Mr. Thorpe has not been blessed with a sense of humor. He has nothing with which to soften the blows of reality."
"It was my fault," Hester said quietly. "I am afraid I was sarcastic. He provokes the worst in me—and I let him. We shall have to try again from a different angle. I cannot think of one yet." She looked at Kristian and forced herself to smile. "He actually suggested that we should busy ourselves with discipline in the hospital and being of comfort to the patients." She gritted her teeth. "Perhaps I should go and say something uplifting?" Her intention was to leave Kristian and Callandra alone for one of the few moments they had together, even if they were only able to discuss the supply of bandages or domestic details of nurses’ boarding allowances, and who should be permitted to leave the premises to purchase food.
Callandra did not look at her. They knew each other too well for the necessity of words, and it was far too delicate a matter to speak of. Perhaps she was also self-conscious. So much was known, and so little said.
Kristian’s mouth curled in acknowledgment of the absurdity of it. Hospital discipline was a shambles where the nurses were concerned, and yet rigidly enforced upon the patients. Patients who misbehaved, used obscene or blasphemous language, fraternized with patients of the opposite sex, or generally conducted themselves in an unseemly fashion, could be deprived of food for one meal or more. Alcohol was banned. Smoking and gaming incurred discharge altogether, regardless of whether the person in question was healed of his or her illness.
For nurses, drunkenness was a different matter. Part of their wages was paid in porter, and they were largely the type of person of whom no better was expected. What other sort of woman scrubs, sweeps, stokes fires, and carries slops? And who but a maniac would allow such women to assist in the skilled science of medicine?
Hester marched off, actually to the apothecary’s store, leaving Callandra alone in the corridor with Kristian.
"Have you heard from Miss Nightingale?" Kristian asked, turning to walk slowly back towards the surgeons’ area of rooms.
"It is very difficult," Callandra replied, trying to choose her words with care. The entire country had a burning respect for Florence Nightingale. She was the perfect heroine. Artists painted pictures of her bending over the sick and injured heroes of the recent war in the Crimea, her gentle features suffused with compassion, lit by the golden glow of a candle. Callandra knew the reality had been very different. There was no sentimentality there, no murmured words of peace and devotion. Miss Nightingale was as much a fighter as any of the soldiers, and a better tactician than most, certainly better than the grossly incompetent generals who had led them into the slaughter. Sh
e was also erratic, emotional, hypochondriacal, and of inexhaustible passion and courage, a highly uncomfortable creature of contradictions. Callandra was not always sure that Hester appreciated quite what a difficult woman Florence Nightingale was. Her loyalty sometimes blinded her. But that was Hester’s nature, and they had both been more than glad of it in the past.
Kristian glanced at Callandra questioningly. He knew little of the realities of the Crimea. He was from Prague, in the Austrian principality of Bohemia. One could still hear the slight accent in his speech, perfect as his English was. He used few idioms, although after this many years he understood them easily enough. But he was dedicated entirely to his own profession in its immediacy. The patients he was treating now were his whole thought and aim: the woman with the badly broken leg, the old man with the growth on his jaw, the boy with a shoulder broken by the kick of a horse (he was afraid the wound would become gangrenous), the old man with kidney stones, an agonizing complaint.
Thank God for the marvelous new ability to anesthetize patients for the duration of surgery. It meant speed was no longer the most important thing. One could afford to take minutes to perform an operation, not seconds. One could use care, even consider alternatives, think and look instead of being so hideously conscious of pain that ending it quickly was always at the front of the mind and driving the hands.
"Oh, she’s perfectly right," Callandra explained, referring back to Florence Nightingale again. "Everything she commands should be done, and some of it would cost nothing at all, except a change of mind."
"For some, the most expensive thing of all," he replied, the smile rueful and on his lips, not in his eyes. "I think Mr. Thorpe is one of them. I fear he will break before he will bend."
She sensed a new difficulty he had not yet mentioned. "What makes you believe that?" she asked.
Even walking as slowly as they were, they had reached the end of the corridor and the doorway to the surgeons’ rooms. He opened it and stood back for her as two medical students, deep in conversation, passed by them on their way to the front door. They nodded to him in deference, barely glancing at her.
